Anterior Knee Pain Case Study - Medical Science Assignment Help

Assignment Task

A promising 17-year-old junior footballer Jake comes in to see you with anterior knee pain. On visual inspection, you notice some mild swelling (effusion) and atrophy (wasting) in the medial compartment of the knee and upper thigh. Jake cannot remember a single specific incident where the knee was badly twisted or he suffered severe trauma to the knee joint. You are concerned about the integrity of the medial (tibial) collateral ligament and the medial meniscus and decide to assess these. You also decide to assess the hip joint and foot mechanics in your initial assessment. Please answer the questions below:

1. In your initial knee assessment, why would you perform a straight leg raise test with the knee extended.

2. In your initial assessment of the hip joint, you perform a Thomas test, as you flex and bring Jake’s leg up to his chest, the same leg abducts away from the midline of his body and the knee extends. What does this tell you about the length of the tensor fasciae latae and rectus femoris muscles on that side of Jake’s body?

3. Starting from a neutral position, how would you change the alignment of Jake’s tibia to apply a valgus stress to the knee to assess the medial (tibial) collateral ligament? Why would you perform this test at 0 and 35° degrees of knee flexion?

4. Briefly describe how you would perform a McMurray’s test to assess the medial meniscus.

5. Briefly describe how you would perform an Apley’s compression test to assess the medial meniscus.

6. List the movements involved in subtalar joint pronation and how excessive pronation may contribute to anterior knee pain.

7. You assess Jake’s hip joint function and he records a positive Trendelenburg test. What does this tell you about the strength of the gluteus medius muscle on the test leg? How could it alter iliotibial band (ITB) function to change patellar tracking to cause anterior knee pain

8. Briefly describe a suitable open kinetic chain exercise that could be used in the early stages of the rehabilitation process to improve Jake’s quadriceps femoris muscle activity and endurance.

9. Jake’s rehabilitation from anterior knee pain is progressing well and your decide to include an unweighted squat exercise into his program. What active range of movement do you use for Jake’s squat exercise and why? What is one important instruction you give Jake about knee joint alignment when performing the squat exercise and why?

10. Utilizing the pyramid of performance, at what stage of the pyramid would you introduce plyometric exercises into Jake’s rehabilitation program? Briefly describe a simple and safe functional lower limb test you could get Jake to do to determine if he is ready to progress to low-level plyometrics.

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